PB2696: QUALITATIVE INTERVIEWS TO DESCRIBE BURDEN IN PATIENTS (PT) WITH THIRD-LINE OR LATER CLL/SLL WITH PRIOR EXPOSURE TO BRUTON TYROSINE KINASE INHIBITOR (BTKI) AND/OR B-CELL LYMPHOMA 2 INHIBITOR (BCL2I)
Authors: Masoom Priyadarshini, Zaneta Balantac, Simran K Tiwana, Shweta S Bapat, Sean Garrison, Mona L Martin
Journal: HemaSphere (2023)

Topic: 35. Quality of life and palliative care Background: CLL/SLL (CLL) is a lifelong cancer with no curative treatment available. Despite the introduction of oral-targeted therapies (eg, BTKi, BCL2i), relapses/retreatments are common. This can lead to increased disease and treatment burden in pts with advanced CLL. However, real-world assessment of this burden is limited, especially among pts who have failed ≥2 prior lines of therapy (LOT), including prior BTKi and/or BCL2i. Aims: To describe pt experience, symptom burden, and treatment satisfaction among pts with third-line or later CLL and prior exposure to BTKi and/or BCL2i therapy. Methods: Adult pts with CLL and a history of ≥2 prior LOTs, including prior BTKi and/or BCL2i treatment, were recruited for qualitative interviews. A recruitment vendor identified potential pts via clinician networks, social media, and pt groups. Interviews were conducted to collect history on LOTs, reasons for treatment discontinuation, inconvenience related to treatment, the severity of symptoms and how bothersome they were, and overall impact on quality of life. Published literature and expert opinion aided the development of the interview discussion guide on CLL symptoms. We used descriptive statistics for demographic variables and a thematic analysis to summarize pt perceptions on qualitative aspects of their treatment. Results: Among the 24 pts who completed the interview, 18 received prior BTKi and 6 received both prior BTKi and BCL2i. Pts were mostly female (54.2%), with a mean age of 59.2 years, and an average time of 6.0 years since initial diagnosis. At the time of the interview, 62.5% of pts were currently receiving treatment for CLL and received an average of 3.8 prior LOTs (median 4.0). Disease progression and side effects were reported as the primary reasons for treatment discontinuation. Fatigue was most frequently reported as the worst symptom, followed by compromised immune system, nausea, vomiting, and weight loss. Fatigue/tiredness was also reported by most pts as their most severe symptom. Other severe symptoms included throat closing, gastritis, weakness, depression, and dry mouth. When asked about the most bothersome symptoms, pts once again reported fatigue, along with irregular heartbeat, nausea, frequent infections, and headaches. Overall, their symptoms impacted pts by hindering daily activities and causing treatment-related inconvenience, fear, and worry. Pts reported that their emotional functioning and relationships were also affected. Side effects, treatment effectiveness, and the overall impact on quality of life were the top worries associated with starting a new treatment. Pts most commonly associated their treatment satisfaction with the effectiveness of the treatment and overall well-being. Summary/Conclusion: Our study showed high disease and treatment-related symptom burden in pts with relapsed or refractory CLL who received multiple LOTs. The disease and its treatments also affected emotional and social well-being. When contemplating their next treatment, quality of life was an important consideration, as well as treatment effectiveness and side effects. These findings highlight the pt experience and priorities among those with advanced CLL. Keywords: Real world data, Chronic lymphocytic leukemia, Retreatment, Patient reported outcomes